The Child Physical Abuse as a Crisis Report (Assessment)

Abstract

Physical child abuse is defined as the cause of non-accidental physical harm to the body and has been on the rise over the years. The victims usually show some unique behaviors and don’t like socializing with people as well as showing deteriorating academic performances and even thoughts of suicide. The parents show some level of depression and lack of concentration at the workplace or in school. To avert this situation, several models under the Evidence Based Program have been advocated. For those children suffering from neglect and physical abuse, the Family partnering model has been endorsed. For the abusive parents and physically abused children, both Parent-Child Interaction Therapy and Multisystemic Therapy are being advocated for. Lastly, for those children under foster care, the Parent Management Training is recommended, though other models are still under review, with promising results.

Physical Child Abuse

Definition and Overview

Child abuse is referred to as the intentional infliction of some kind of physical injury to a child especially by the parent, other family members, or his/her caretaker: it is non-accidental (American Academy of Child and Adolescent Psychology, 2001). the physical abuse can include such acts as punching, kicking, burning, biting, hitting, and even whipping and can be seen through such indicators as lacerations, burns, welts, human bite marks, skin discoloration, injuries on the head, and some other unexplained bruises that are at various healing stages (Prevent Child Abuse North Carolina, 2002).

Child physical abuse cases have been on the rise; and documented pieces of evidence show that in 2001 alone, about 168,278 children (18.6% of all substantiated cases) were adjudged to be as a result of child physical abuse. Also in the same year, it was found to be responsible for 342 death cases, representing 26.3% of all child abuse and neglect cases. A combination of the two (child abuse and neglect) resulted in 285 extra deaths (Ibid).

Apart from the physical impacts of the physical abuse, there is always a remarkable change in the behaviors of the victim as well as a psychological effect: the victim usually avoids contact with people and puts on clothes that purposely help conceal the injuries and there is general emotional destabilization. Research has shown that even though any family can experience physical abuse, those that are undergoing economic hardship, those with a history of alcohol or any other drug abuse, domestic violence as well as being deserted by close friends and relatives is more vulnerable (Straus and Gelles, 1990)

As a consequence, therefore, physical abuse of children may bring one’s self-image into disrepute, may also result in drug abuse, impairment of learning, thoughts of committing suicide as well as signs of depression may crop in. there may be conduct disorder and sexually act out (Kolko, 2001). The adults involved are not spared either as they find it difficult to develop strong intimate relationships and also suffer from medical abuse and illness, depression, anxiety, or they find it difficult to concentrate at work station (Widom and Maxfield, 2001).

A child that is physical abuse has been described as a vicious circle since studies have found out that those who are physically abused as children carry on with the same brutality when they grow up, making the circle long and continuous (Ibid).

Interventions to Physical Child Abuse

Evidence-Based Practice can (EBP) be used to intervene in the crisis of physical abuse of children. EBP therefore can be defined as the high fidelity and competent employment of acts that have been proven to be safe and effective, mostly in Randomized Controlled Trials (RCTs), and is generally a new concept with almost an equal measure of proponents and critics (Kauffman Best Practices, 2004). The feature of EBP is summarized as:

Source: Children and Youth Service Review; pg 1101

Under this program, the evidence that supports the intervention measures that are adopted is reviewed by a panel of experts that are charged with looking at the evidence from the research. They then look at each model of intervention against the already established criteria for the support levels. And so far, two projects on child abuse and neglect have been concluded and were funded by US Office for Victims of Crime (OVC) in 2001: one narrowed on the mental health interventions for victims of intrafamilial physical or sexual abuse and their families. After undergoing all the processes, one treatment called attachment therapy (Evergreen Model) was found to have a significant potential for harm (Kolko, 1996).

Case Studies under EBP

EBP for preventing Physical Abuse and Neglect:

In this case, the Family Partnership model (Olds et al, 1998) has been found to have considerable trial evidence for a variety of benefits and therefore is the one currently being advocated for

EBP for Physically Abused Children and Abusive Parents

Here, the Parent-Child Interaction Therapy has been endorsed. It is a live-coached parent training intervention (Chambless and Ollendick, 2001). This therapy has also been found to be able to significantly lower the future incidences of behaviors that are physically abusive from the parents (Chaffin et al., 2004). Another model that has been proposed is Multisystemic Therapy, especially after the first trial (Brunk, Henggeler, and Whelan, 1987).

EBP for Children with Foster Parents

In this case, the Parent Management Training has been endorsed as the ideal behavioral model (Kazdin, 1997). Other programs, each with a considerable degree of support are also in the pipeline. They include The Incredible Years series (Webster-Stratton and Reid, 2003) and Triple-P models (Sanders, Cann, and Markie-Dadds, 2003).

References

1. American Academy of Child and Adolescent Psychology. (2001). Glossary.
2. Brunk, M., Henggeler, S. W., and Whelan, J. P. (1987). “Comparison of multisystemic therapy and parent training in the brief treatment of child abuse and neglect.” Journal of Consulting and Clinical Psychology; 55, 171-178
3. Chaffin, M., Silovsky, J., Funderburk, B., Valle, L. A., Brestan, E. V., Balachova, T. (2004). “Parent-Child interaction therapy with physically abusive parents: Efficacy for reducing future abuse reports.” Journal of Consulting and Clinical Psychology; 72, 491-499
4. Chambless, D. L., & Ollendick, T. H. (2001). “Empirically supported psychological interventions: Controversies and practices.” Annual Review of Psychology; 52, 685-716.
5. Ibid
6. Kauffman Best Practices Project. (2004, March). Closing the quality chasm in child abuse treatment: Identifying and disseminating best practices: Findings of the Kauffman best practices project to help children heal from child abuse. Charleston (SC): National Crime Victims Research and Treatment Center.
7. Kazdin, A. E. (1997). “Parent management training: Evidence, outcomes, and issues.” Journal of the American Academy of Child & Adolescent Psychiatry; 36, 1349-1356
8. Kolko, D. J. (1996). “Individual cognitive behavioral therapy and family therapy for physically abused children and their offending parents: A comparison of clinical outcomes.” Child Maltreatment; 1, 322-342
9. Kolko, D. J. (2001). Child Physical Abuse. University of Pennsylvania: School of Medicine.
10. Olds, D. L., Henderson, C. R., Cole, R., Eckenrode, J., Kitzman, H., Luckey, D. (1998). “Long- term effects of nurse home visitation on children’s criminal and antisocial behavior: 15- year follow-up of a randomized controlled trial.” Journal of the American Medical Association; 280, 1238-1244
11. Prevent Child Abuse North Carolina. (2002). Recognizing and Reporting child abuse. Web.
12. Sanders, M. R., Cann, W., and Markie-Dadds, C. (2003). “The triple P-positive parenting program: A universal population-level approach to the prevention of child abuse.” Child Abuse Review. 12, 155-171.
13. Straus, M., and Gelles, R. (1990). Physical Violence in American Families: Risk Factors and Adaptations to Violence in Families. New Brunswick, NJ: Transaction Publication
14. Webster-Stratton, C., and Reid, M. J. (2003). “The Incredible year’s parents, teachers, and children training series: A multified treatment approach for young children with conduct problems”. In A.E Kazdin (Ed.). Evidence-based psychotherapies for children and adolescents. (pp. 224-240). New York. NY, US: Guilford Press.
15. Widom, C. S., & Maxfield, M. G. (2001). An update on thee “Cycle of Violence”. National Institute of Justice.